{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T04:48:46Z","timestamp":1782103726595,"version":"3.54.5"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Peripheral Nervous Sys"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diabetic painful neuropathy is a cause of significant disability and sleep disturbance but may be undiagnosed in up to 80% of patients with diabetes. Various neuropathic pain (NP) questionnaires have good diagnostic utility but are impractical in resource\u2010constrained and busy clinical settings. A simple sCreening Tool (ACT) was developed as a concise, patient\u2010led tool to rapidly detect NP. This study evaluates the screening validity and psychometric properties of ACT compared with the DN4 questionnaire (reference standard).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an observational study employing clinic\u2010based recruitment of patients with diabetes at a tertiary outpatient clinic in Guayaquil, Ecuador. All enrolled participants completed the ACT, DN4, and MNSI questionnaires during the study visit. MNSI was administered as part of the study to confirm the diagnosis of DPN using predefined cut\u2010offs (MNSI\u2010q\u2009\u2265\u20094 and MNSI\u2010e\u2009\u2265\u20092.5). Time to completion, inter\u2010item consistency, sensitivity, specificity, Youden's index, and the area under the receiver operating characteristic (ROC) curve were calculated for ACT using DN4\u2009\u2265\u20094 as the criterion for NP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 300 participants (median age 63\u2009years, diabetes duration 10\u2009years), 65 (21.7%) had NP per DN4. Total ACTq+e (questionnaire+examination) yielded a cut\u2010off score of \u2265\u20096 items as optimal, with area under the ROC curve 0.836, sensitivity 80.0% and specificity 75.7% for painful DPN. ACT demonstrated moderate internal consistency (Cronbach's alpha\u2009=\u20090.65) and was well received by patients and clinicians on face validity. The completion time for ACT was comparable to that of DN4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The ACT tool is a rapid screening tool for identifying neuropathic pain in the busy clinic, with acceptable sensitivity and specificity compared to DN4. The brevity and ease of patient self\u2010administration of ACT make it promising for integration into busy outpatient workflows to improve the diagnosis of painful DPN.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jns.70118","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:10:01Z","timestamp":1773879001000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A New Simple\n                    <scp>SCreening<\/scp>\n                    Tool for Painful Diabetic Neuropathy (\n                    <scp>ACT<\/scp>\n                    ) in Ecuador"],"prefix":"10.1111","volume":"31","author":[{"given":"Hoda","family":"Gad","sequence":"first","affiliation":[{"name":"Research Department Weill Cornell Medicine\u2010Qatar  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Cristina","family":"Moreno","sequence":"additional","affiliation":[{"name":"Endocrinology Residency Program Universidad Espiritu Santo (UEES)  Guayaquil Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angel","family":"Pluas","sequence":"additional","affiliation":[{"name":"Endocrinology Residency Program Universidad Espiritu Santo (UEES)  Guayaquil Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Belen","family":"Tello","sequence":"additional","affiliation":[{"name":"Endocrinology Residency Program Universidad Espiritu Santo (UEES)  Guayaquil Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maribel","family":"Burgos","sequence":"additional","affiliation":[{"name":"Endocrinology Residency Program Universidad Espiritu Santo (UEES)  Guayaquil Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karla","family":"Diaz","sequence":"additional","affiliation":[{"name":"Endocrinology Residency Program Universidad Espiritu Santo (UEES)  Guayaquil Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estefan\u00eda","family":"Icaza","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency Program Universidad Espiritu Santo (UEES)  Guayaquil Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mabel","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Research Ethics Committee for Human Health Universidad Laica Eloy Alfaro De Manabi (ULEAM)  Manta Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariella","family":"Vecchionacce","sequence":"additional","affiliation":[{"name":"Endocrinology Department Hospital General Del Norte De Guayaquil IESS Los Ceibos  Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7188-8903","authenticated-orcid":false,"given":"Rayaz A.","family":"Malik","sequence":"additional","affiliation":[{"name":"Research Department Weill Cornell Medicine\u2010Qatar  Doha Qatar"},{"name":"Institute of Cardiovascular Medicine, University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Solis","sequence":"additional","affiliation":[{"name":"Endocrinology Department Hospital General Del Norte De Guayaquil IESS Los Ceibos  Ecuador"},{"name":"Coordinator and Tutor, Endocrinology Postgraduate Program Universidad Espiritu Santo (UEES) Hospital General Del Norte De Guayaquil IESS Los Ceibos  Guayaquil Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.1225"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc23-1749"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S37415"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-98565-w"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"e_1_2_8_7_1","unstructured":"Prevention. 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